A FOUR WEEK THERAPY WITH SYSTANE IMPROVES OCULAR SURFACE PARAMETERS IN DRY EYE PATIENTS.

Purpose. Systane® Lubricating Eye Drops (Alcon Forth Worth, Inc.) contains PEG 400/PG and the gelling agent hydroxypropyl-Guar (HP-Guar). Systane is designed to provide dry eye relief by means of longer retention time on the ocular surface that may promote epithelial repair. We evaluated Systane in an open trial in patients complaining of moderate dry eye symptoms. Methods. A total of 50 subjects were enrolled (age 57.6 + 15.4; 40 women, 10 men) ; inclusion criteria were based on a tear break-up time (TBUT) < 10 sec without corneal epithelial staining. Six symptoms of ocular irritation were rated on a four-point scale. Conjunctival injection was graded. Schirmer test, conjunctival imprint cytology, inflammation score given by scraping cytology, tear protein content (serum albumin exudated in tears, lysozyme, lactoferrin, lipophillin, lipocalins) were also evaluated in both eyes. Patients were instructed to instill Systane four times a day for four weeks. Satisfaction with the product was rated at the end of the study. Media of results in both eyes was considered for statistical evaluation; the Wilcoxon test for paired data was applied, p< 0,05 was considered as statistically significant. Results All patients regularly instilled Systane and completed the study; results are expressed baseline vs endpoint. Significant reduction was demonstrated for ocular irritation symptom scores (1.44 vs 0.94, p 0.0001) and exudated serum albumin in tears (0.268 + 0.035 vs 0.198 + 0.075 mg/ml, p 0,03), while improvement was shown for patient’s satisfaction score (3.41 vs 3.94, p 0.0001), TBUT (6.9 + 0.9 vs 8.5 + 1.5 sec, p 0.0001), tear lipocalins (9.4 + 2 vs 11.3 + 2.3, results in %, p 0.03). A significantly increased proportion of patients with normal conjunctival injection (10 vs 22, results in %, p 0.01) was observed after one month follow up. Tear production, conjunctival cytology dryness, conjunctival inflammation score, tear protein content showed no significant change. Conclusions. Systane proved effective in reducing the symptoms of dry eye and it was overall well accepted. This finding is likely to be related with improved stability of tear film associated to tear lipocalin increase